You have probably felt it before —
that odd sensation or flutter when
your heart gets out of rhythm.
Usually, the feeling passes rather quickly, but
for others, arrhythmia, a disorder of the
regular rhythmic beating of the heart, is a
serious condition. Patients who deal with life-threatening
types of arrhythmias are at risk for
sudden heart attack, and if not treated
immediately with defibrillation, can die.
“Ninety-five percent of people with an ICD will survive an episode of sudden
cardiac arrest.”

According to Morbidity and Mortality
Weekly Report, 460,000 people die suddenly
in the United States each year due to cardiac
arrest. That is more than from AIDS, breast
cancer and lung cancer combined. For these
patients, an implantable cardioverter
defibrillator (ICD) can be a lifesaver. The
small device, implanted surgically in the
upper chest, treats the abnormal heart
rhythms, particularly fast arrhythmias in the
heart’s lower chambers or ventricles.
According to the 1999 ENDOTAK Trial,
ninety-five percent of people with an ICD will
survive an episode of sudden cardiac arrest.
The LATITUDE Patient Management
System

Eisenhower Medical Center not only
performs the procedure to implant the ICD
device, but also offers a new technology to
manage the appropriate patients after surgery.
“As soon as the ICD has been implanted,
monitoring the device and frequent follow-up
become extremely important,” says Sharon
Duncan, RN, Supervisor, Electrophysiology
Lab, at Eisenhower Smilow Heart Center.
“The heart and the condition of the heart can
fluctuate, and regular follow-up is needed to
make sure the doctor is aware of any changes
or any need for the ICD to be adjusted.”

In the past, patients would have to visit
their doctor’s offices frequently to be
monitored. Now, a number of new technologies are being developed to
alleviate the number of office visits
patients need to make. Using the
LATITUDE Patient Management
SystemTM, one of
the systems currently available, they are sent home with a “communicator,” a
piece of equipment that plugs into any standard phone jack and fits easily on a
nightstand or end table. The device monitors a patient’s heart health daily or
weekly and displays a white light reminder when it is time to check their
device. The patient simply holds a small wand over the implanted ICD for about
10 to 15 seconds.The wand “absorbs” the information, and it is sent
to the patient’s physician. “If a patient’s parameters are really out of the
norm and major changes are sensed by the equipment, the physician and the
medical company that provides the equipment will both be notified immediately,”
says Carl Enzor, RN, Director, Renker Wellness Center, who has been working with
ICD patients and other cardiac rehabilitation patients to monitor their exercise
and recovery.

A smaller group of patients with
more serious heart problems and a
history of heart failure are referred to
Eisenhower’s Glickman Heart Failure
Clinic. “These patients are at higher risk
for cardiac issues, and we watch their
medications and diet a little closer.
There are also a group of nurses who
see these patients on a regular basis,”
says Enzor. “Ultimately, all the patients
with ICDs still need to have regular
follow-up visits, but this system reduces
the number of in-office visits the
patient has to make and frees up time
for them to live their lives.”